Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kaitlin Rose Grigoryev

Individual provider Family Nurse Practitioner · NPI 1619601770

Kaitlin Rose Grigoryev is a Nurse Practitioner in Germantown, Wisconsin. Qualified in 2022, 4 years ago. Practices with Ascension Medical Group-Southeast Wisconsin Inc, a 555-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
4
Licensed in
WI
In the registry since
2022

Practice location Address checks out

N112W15415 Mequon Rd
Germantown, WI 53022-3410
Phone: (262) 250-7800
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 13152 (WI)

Record details

NPI number1619601770
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 14, 2022
Last updated in NPPESFebruary 15, 2024
Certification dateFebruary 15, 2024
Mailing address400 W River Woods Pkwy, Glendale, WI 53212-1060

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Ascension Medical Group-Southeast Wisconsin Inc — 555 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Germantown